ASTDD Best Practices Project Improving the Oral Health of Children, Families and Communities

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ASTDD Best Practices Project Improving the Oral
Health ofChildren, Families and Communities

• Lynn Douglas Mouden, DDS, MPH
• Julie Tang, DMD, MPH
• Jay Balzer, DMD, MPH

Supported By CDC Cooperative Agreement
U58/CCU723036-04 HRSA Cooperative Agreement
5-U44-07-001
MCH Federal/State Partnership Meeting
Alexandria, VA Oct. 16, 2007
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Association of State and Territorial Dental
Directors (ASTDD)
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Objectives

• Take our lessons on using best practices concepts
  to build stronger programs
• Use our example to help apply best practices
  methodology/processes to your focus areas
• Share our references and tools with your
  agency/organization and stakeholders interested
  in oral health, CSHCN and system development.

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ASTDD Best Practices Project Helping State
and Local Programs Develop Their Best Practices
A Bottom-Up Approach

• Julie Tang, DMD, MPH
• ASTDD Best Practices Project Director

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ASTDD Best Practices Project A Best Practice
Approach to Promote Oral Health of Children with
Special Health Care Needs

• Jay Balzer, DMD, MPH
• ASTDD SHCN Coordinator

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ASTDD Best Practices Project Building Blocks
of Best Practices Infrastructure and Systems
Development

• Lynn Douglas Mouden, DDS, MPH
• Director, Office of Oral Health, Arkansas Dept.
  of Health
• Chair, ASTDD Best Practices Committee

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ASTDD Best Practices Project Improving the Oral
Health ofChildren, Families and Communities
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ASTDD Best Practices Project

• Helping State and Local Programs
• Develop Their Best Practices
• A Bottom-Up Approach
• Julie Tang, DMD, MPH
• ASTDD Best Practices Project Director

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Need for a Best Practices Project

• Oral Health in America
• A Report of the
• Surgeon General

Building Infrastructure and Capacity in State
and Territorial Oral Health Programs Prepared
by ASTDD
National Call To Action To Promote Oral Health 
A Public-Private Partnership Under the
leadership of The Office of the Surgeon General
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ASTDD Best Practices ProjectPurpose

• Build more effective state, territorial and
  community oral health programs.

Infrastructure Capacity National Call to
Action Healthy People 2010
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ASTDD Best Practices ProjectGoal

• Promote the development of best practices by
  state, territorial and community oral health
  programs to enhance the oral health of Americans
  and reduce disparities.

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Uses ofBest Practice Information

• Use successful practices as building blocks
• Share ideas lessons learned
• Raise awareness of oral health
• Promote collaborations
• Update guidelines

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End-Users ofBest Practice Information
Dental Directors
Government Officials Staff
Public Health Programs
Best Practices
Professional Advocacy Organizations
Coalitions
Consumers
Funders
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Best Practice ConceptsShaping the Project

• 1. A best practice is a methodology
• that, through experience research,
• has proven to reliably lead to a
• desired result.
• 2. Using best practices is a commitment
• to using all the knowledge technology
• at one's disposal to ensure success.

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Best Practice ConceptsShaping the Project

• 3. Best practice does not commit
• people or organizations to one
• inflexible, unchanging practice.
• 4. Best practices do not have one
• template or form for everyone to follow.

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Best Practice ConceptsShaping the Project

• 5. Transfer of best practices is an
• interactive, ongoing dynamic
• process that cannot rest on a static
• body of knowledge.
• 6. Best practice is a philosophical
• approach based around continuous
• learning and improvement.

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State InputShaping the Project

• Best Practice (BP) criteria
• Types of BP information
• Dental public health strategies
• Self-reported successful practices

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Best Practice
Best from whose perspective and using what
criteria?

• Impact/Effectiveness
• Efficiency/Cost Effectiveness
• Demonstrated Sustainability
• Collaboration/Integration
• Objectives/Rationale

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Projects Primary RoleServing as an Information
Broker

• Best Practice Approach Reports
• Successful State/Community Practices
• Web-based Resources

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Best Practice Approach ReportContent

• Description
• (public health strategy)
• Guidelines recommendations
• Research evidence
• Best practice criteria
• State/community practice examples
• References attachments (tools)

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Best Practice Approach Reports

• 1. State Oral Health Surveillance System
• 2. State Oral Health Coalitions
• 3. State Oral Health Plans
• 4. Mandate for a State Oral Health Program
• 5. Community Water Fluoridation
• 6. School Sealant Programs
• 7. School Fluoride Programs
• 8. Workforce Development
• 9. Oral Health of Individuals with SHCN

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Successful State/Community PracticesContent

• History
• Justification
• Inputs, Activities, Outputs Outcomes
• Budget Estimates
• Lessons Learned/Plans for Improvement
• Available Information Resources
• Best Practice Criteria
• Contact Persons for Inquiries

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Successful State/Community PracticesDatabase

• 49 states provided submissions
• 200 successful practices described
• An expanding collection

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ASTDD Web Site (www.astdd.org)
Best Practices
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Best Practices Front Page
View Best Practice Approach Reports
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A Best Practice Approach Report
Table of Contents
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A Best Practice Approach Report
State Oral Health Plans and Collaborative Planning
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Successful Practice Descriptions
Nevadas State Oral Health Plan
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Projects Developing RoleBuilding a Supportive
Environment

• A support network
• Partners support
• Building of evidence
• State of the science
• Capacity building tools
• Program policy evaluation

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ASTDD Best Practices ProjectInfluence

• Outcomes
• - Access to best practice information
• - Observed best practice approaches
• - Infrastructure system development
• How end-users are using
• best practice information

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Ongoing and DynamicDevelopment of Best Practices
Identify Best Practices
Collaboration Integration
Science and Art
Supportive Environment
Cultivate Best Practices
Promote Best Practices
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ASTDD Best Practices ProjectOur Journey
Continues
                            Optimal oral
health across the lifespan

• Julie Tang, DMD, MPH
• ASTDD Best Practices Project Director
• jtang_at_astdd.org

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ASTDD Best Practices Project A Best Practice
Approach to Promote Oral Health of Children with
Special Health Care Needs

• Jay Balzer, DMD, MPH
• ASTDD SHCN Coordinator

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New Best Practice Approach Report
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National Survey CSHCN
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Background Issues

• Oral health needs of CSHCN
• Access to care system limitations
• Strategic framework
• Empower individuals and families
• Prepare the dental workforce
• Improve the financing system
• Organize community resources

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Guidelines and Recommendations from
Authoritative Sources

• SG Report Persons with Mental Retardation
• SG Report Oral Health
• HP 2010
• National Agenda for CSHCN
• ASTDD Guidelines for state programs

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Research Evidence

• Empower individuals and families
• Prepare the dental workforce
• Improve the financing system
• Organize community resources

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Best Practice Criteria

• Impact/Effectiveness
• Efficiency
• Demonstrated sustainability
• Collaboration/Integration
• Objectives/Rationale

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State Practice Examples

• 16 state practice submissions
• From 13 states
• Within 4 strategic components

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Strategic Component 1

• Empower individuals and familiesand advocate for
  their oral health.
• Example
• The South Carolina Online
• Dental Directory for Individuals
• with SHCN

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Strategic Component 2

• Prepare the dental workforce.
• Example
• Nisonger Center Dental Program
• Training Dental Professional Students
• in a UCEDD

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Strategic Component 3

• More responsive financing system.
• Example
• New Mexico Special Needs Dental Procedure Code

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Strategic Component 4

• Organize community resources.
• Example
• Butler County
• Dental Case Management

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Resources

• In Support of the National Agenda
• Oral Health Version
• (handout)
• BP Approach Report Announcement (handout)
• ASTDD Web Site at www.astdd.org

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ASTDD Best Practices Project Building Blocks
of Best Practices Infrastructure and Systems
Development

• Lynn Douglas Mouden, DDS, MPH
• Director, Office of Oral Health, Arkansas Dept.
  of Health
• Chair, ASTDD Best Practices Committee

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Building Blocks

• Block 1
• Why do an oral health
• best practices project?
• Block 2
• Why does an oral health project matter to you?

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Best Practices in Oral Health

• Building infrastructure and capacity
• State Mandate

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Statutory Mandate for a State Oral Health Program
Arkansas
Arizona
Missouri
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Access to Oral Health Care Services Workforce
Development
Ex Dentists CHCs, Medicaid, Access Grants
Ex Auxiliary personnel Dental Health Aide,
Tooth Tutor
Ex Non-Dentoids Open Wide, Bright Smiles
for Bright Futures
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Best Practices in Oral Health

• Building infrastructure and capacity
• Replicating model programs

Seal the State in 98 North Carolina
Seal the State in 2008 Arkansas
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Best Practices in Oral Health

• Building infrastructure and capacity
• Replicating model programs
• Training new dental directors

ASTDD Mentoring Project
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Best Practices in Oral Health

• Building infrastructure and capacity
• Replicating model programs
• Training new dental directors
• New funding opportunities

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State-based Oral Health Surveillance System
CDC Capacity and Infrastructure Grants

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Why it Matters to You

• Translation between programs

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Why it Matters to You

• Translation between programs
• State to local, within agencies

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Why it Matters to You

• Translation between programs
• State to local , within agencies
• Coalitions

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State Oral Health Coalitions and Collaborative
Partnerships
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Why Have Coalitions?
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SMILES AR, U.S.TM
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Why it Matters to You

• Translation between programs
• State to local , within agencies
• Coalitions
• State plans

7 to 34
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Why it Matters to You

• Translation between programs
• State to local , within agencies
• Coalitions
• State plans
• Workforce Whos going to do the job when you
  retire?

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The Future is Now

• Infant and Toddler Oral Health
• School and Adolescent Oral Health

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QUESTIONS?
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